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Chronic Kidney Disease and Nutrition Support
Winnie Chan1,2
1School of Sport, Exercise and Rehabilitation Sciences, The University of Birmingham, Edgbaston, Birmingham, United Kingdom.
Summary
Protein-energy wasting (PEW) in chronic kidney disease (CKD) patients can be managed with nutrition support. Dietary counseling, oral nutrition supplements (ONSs), and parenteral nutrition (PN) are key interventions.
Area of Science:
- Nephrology
- Clinical Nutrition
Background:
- Protein-energy wasting (PEW) is prevalent in chronic kidney disease (CKD) patients, especially those on maintenance dialysis.
- PEW negatively impacts patient outcomes and requires effective nutrition support strategies.
Purpose of the Study:
- To review and outline various nutrition support methods for managing PEW in CKD patients.
- To detail the indications and feasibility of different parenteral nutrition (PN) modalities.
Main Methods:
- Literature review of nutrition support interventions for PEW in CKD.
- Analysis of dietary counseling, oral nutrition supplements (ONSs), and various forms of PN (partial and total).
Main Results:
- Dietary counseling is the cornerstone of PEW management.
- ONSs are recommended when dietary counseling is insufficient.
- Enteral and parenteral nutrition (PN), including intraperitoneal PN (IPPN) and intradialytic PN (IDPN), are options when oral intake is inadequate.
- Total PN is reserved for patients with gastrointestinal dysfunction or when other methods fail.
Conclusions:
- A stepwise approach to nutrition support, starting with dietary counseling and progressing to more advanced methods like PN, is crucial for managing PEW in CKD.
- Partial PN (IPPN, IDPN) and total PN offer viable solutions for specific patient populations with inadequate nutrient intake.
Keywords:
chronic kidney diseaseenergyenteral nutritionnutrition requirementsnutrition supportparenteral nutritionproteinMore Related Videos
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